HIV-positive patients undertaking ART have longer infertility histories than age-matched control subjects

Abstract

Objective: To review 5 years of assisted reproductive treatments (ART) provided to couples affected by human immunodeficiency virus (HIV).

Design: Age-matched cohort study.

Setting: University-based tertiary center.

Patient(s): Couples in whom the male (n = 87), female (n = 57), or both (n = 17) partners were HIV infected. The first ART cycle was compared with three sets of age-matched control subjects (3-to-1) which included 261, 171, and 51 couples, respectively.

Intervention(s): ART in HIV-infected couples and age-matched controls.

Main outcome measure(s): Infertility duration and ART outcome.

Result(s): When initiating ART, all three HIV-infected groups had longer infertility histories, computed from when conception was attempted or infertility diagnosed, compared with noninfected age-matched control subjects. Outcome, however, was not different when only the male or female partner was infected, though with a trend toward higher cancellation and lower pregnancy rates. When both partners were HIV infected, cancellation were higher and pregnancy rates lower (12% versus 41.2%), than in age-matched control subjects.

Conclusion(s): Our data showed longer infertility histories in all HIV-infected couples when undertaking their first ART. Outcome, however, was not altered when only one partner--male or female--was HIV infected. Efforts should therefore aim at assuring that HIV-infected couples access ART as promptly as their noninfected counterparts.